Acute lymphoblastic leukemia (ALL) is a common hematopoietic malignancy. The initial complete remission rates of adult ALL reach over 80%, but most of the patients eventually relapse and the long-term survival re-mains poor. This article reviewed advances in the biological features and treatment of adult ALL during the past decade with a view to further improving the survival quality rate of the patients.

OBJECTIVETo develop a life quality scale suitable for idiopathic pulmonary fibrosis (IPF) patients, objectively reflecting its changes.

METHODSAuthors first put forward a theoretical structure model of a scale according to patient-reported outcome (PRO) scale formulation principle by combining basic theories of Chinese medicine (CM). Then authors developed an initial scale on the basis of various life quality scales for respiratory disease patients by using structural decision making. Totally 34 patients with confirmed diagnosis of IPF were tested by questionnaire. Items were screened using expert importance scoring method, factor analysis, correlation coefficient method, Cronbach's alpha coefficient method. IPF patient reported outcomes (IPF PRO, IP) were finally defined.

RESULTSA new IP scale was developed covering three areas and 38 items. Pearson correlation coefficient for correlation analysis of clinical symptom scores in ST-George Respiratory Questionnaire and IP scale was 0.828 (P < 0.01). Pearson correlation coefficient for correlation analysis of activity ability scores was 0.929 (P < 0.01). Pearson correlation coefficient for correlation analysis of total scores was 0.862 (P < 0.01). By reliability of IP scale itself (reliability) analysis, Cronbach's alpha coefficient was 0.713. By using factor analysis method for data analysis, KMO statistics was 0.902.

CONCLUSIONIP scale fully reflected the connotation of IPF patients' quality of life, so it could be used as CM clinical therapeutic effect evaluation tool.

Objective To evaluate the operation of laparoscopic splenectomy(LS),its safety and clinical effects.Methods Literature of the advances of LS were reviewed and analyzed.Results With the development of technology and surgical technique,the indications for LS were widened,the size of spleen plays an important role in the clinical outcome of LS.Conclusion LS has all the advantages of minimally invasive surgery.The application of hand-assisted technique is safe and feasible for giant spleen.With the accumulation of surgical experiences and technique development,LS will be extensively used in clinic.

Objective To investigate the relationships between the expressions of intercellular adhesion molecule 1(ICAM-1),heat shock protein 70(HSP70) and acute rejection after pancreas allotransplantation in miniature swine.Methods Ultrasound guided biopsies of the pancreas and histopathologic examination were performed after the miniature swine models of pancreas allotransplantation were established.According to the histological change,the samples were divided into group Ⅰ(no rejection),group Ⅱ(mild acute rejection),group Ⅲ(moderate acute rejection)and group Ⅳ(serious acute rejection).The expressions of ICAM-1 and HSP70 were analyzed with immunohistochemistry and imaging.Results The expressions of ICAM-1 and HSP70 were increased when acute rejection occurred after pancreas allotransplantation in miniature swine.The levels of ICAM-1 and HSP70 were sequentially high when acute rejection was serious.Conclusion ICAM-1 and HSP70 were involved in pancreas allograft rejection and useful for early diagnosis of acute rejection after pancreas transplantation.

Objective To explore therapeutic efficacy of endoscopic biliary stent placement in the management of bile leakage following hepatobiliary surgery.Methods 11 cases of bile leakage following hepatobiliary surgery were reviewed retrospectively from January 2001 to December 2005.New clinical classifications of bile leakage were proposed: type I,leakage from cystic duct;type II,leakage from extrahepatic bile duct(diameter of leakage less than 1/3 diameter of biliary duct was type IIA;more than 1/3 was type IIB);type III,leakage from intrahepatic bile duct(leakage from intrahepatic bile duct cecum was type IIIA;leakage from intrahepatic bile duct under draining hepatic segments was type IIIB;above draining hepatic segments was type IIIC);type IV,leakage from Luschka duct.Results In 11 cases,there were 6 cases of type I,2 cases of type IIA,1 case of type IIIA,and 2 cases of type IIIB.4 cases were placed only stents,and Oddi sphincterotomy combined with stent placement were performed in 7 cases.Stents were taken out at 3 weeks(6 cases),1 month(2 cases),2 weeks(1 case),6 months(1 case) and 9 months(1 case) postoperatively.Abdominal pain was relieved in 11 cases after endoscopic treatment,with disappearance of biliary drainage from abdominal cavity and subsidence of jaundice.1 case was followed up for 6 months,and other 10 cases were followed up for 1-3 years,with no recurrence of abdominal pain,fever,jaundice and seroperitoneum,and hemobilirubin became normal.Conclusions Endoscopic biliary stent placement is one of effective therapeutic procedures in the management of most bile leakage following hepatobiliary surgery.New classification of bile leakage may be taken as a guide to select therapeutic procedures.

Objective To establish a successful model for pancreaticoduodenal allotransplantation with enteric drainage in piglet and surveillance acute rejection by biopsy.Methods We implemented the model same as protocol of clinical pancrease transplantation.40 piglets were divided into donors and recipients randomly.20 times experimental operation were finished. The total pancreas with a short segment of duodenum was transplanted to a recipient by anastomoses of vessels to the recipient iliac vessels and small bowel segment to the jejunum with enteric drainage. During operation, mean arterial pressure(MAP), central venous pressure(CVP)were monitored. The levels of amylase activity in blood were investigated.Doppler color blood flow ultrasonography was used to evaluate blood flow of pancreatic allografts,and ultrasound-guided percutaneous pancreas allograft biopsy and histopathologic examination were performed.Results The successful rate of operation was 90%. Recipient's MAP was decreased after the reopening of inosculated blood vessels.(P

Background and objectives To investigate the effect of hepatocyte growth factor (HGF) on left ventricular (LV) remodeling after acute myocardial infarction (AMI). Methods AMI was produced by ligation of proximal left anterior descending coronary artery(LAD) in 12 mongrel canines. These animals were randomized into 2 groups. In HGF group (n=6), canines were injected with pcDNA3-HGF lml (about 300ug) at the margin of infarcted myocardium; in control group (n=6) canines were injected with equal volume of normal saline. Cardiac function and left ventricular remodeling were evaluated with echocardiography at 1, 4, 8 weeks after MI. LV myocardium specimens were obtained at 8 weeks and stained with hematoxylin and eosin for histological examination or with sirius red to assess the collagen content. Results Compared with control group, LVEF in HGF group was significantly higher at 4 weeks (49.61+6.66 vs 39.84+6.39; P＜0.05) and at 8 weeks (51.57+8.53 vs 40.61+7.67; P＜0.05) after AMI, while LVESV was significantly lower in HGF group than that in control group at 8 weeks after AMI (18.98+3.47 vs 25.66+5.86; P＜0.05). Posterior left ventricular wall thickness decreased significantly from 1 wk to 8 wks after AMI in control group, while remained unchanged in HGF group. Compared with control group, histological examination showed more neovascularization and less scar, and sirius red staining indicated higher volume of type Ⅲ collagen (7.10±4.06% vs 3.77±1.09%; P＜0.05) and lower collagen Ⅰ/Ⅲ ratio value (1.11±0.52 vs 2.94±2.48; P＜0.05)in HGF group. Conclusion HGF gene transfer might improve cardiac function and LV remodeling after acute myocardial infarction by stimulating angiogenesis, reducing fibrosis, and reducing myocardial scarring.

In order to treat or prevent portal vein metastases of liver cancer, intraportal chemotherapies were carried on in 18 and in 42 patients with and without portal vein thrombosis. The agents used were Pharmorubicin 30 mg, Mitomycin—C 8 mg and 5—Flurouracil 500 mg. The results showed that the incidence of portal thrombosis in preventive group (19.04％) was lower than that in control group (38.9％) (P

Objective To investigate the effects of three procedures for hysterectomy.Methods The clinical characteristics of 370 cases who respectively received hysterectomy by total transabdominal hysterectomy(TAH,150 cases),transvaginal hysterectomy(TVH,120 cases),or laparoscopically assisted vaginal hysterectomy(LAVH,100 cases)were analyzed and their effects and outcomes and the expenses for medical treatment were compared from 2000 January to 2005 December.Results The average operation time of TAH,TVH and LAVH was(78?28) minutes,(102?35)minutes,(119?28)minutes respectively.The average operation time of TAH was significantly shorter than that of TVH and LAVH groups(P＜0.01).The volume of hemorrhage during operation in TAH group was less than that of other two groups significantly[TAH(53?29)ml,TVH(110?35)ml,LAVH(93?50 )ml](P＜0.01).The average time of bowel function recovery in TAH group[(42?7)hours]was significantly longer than that of TVH[(23?5)hours]or LAVH[(25?4) hours]groups(P＜0.01).The average hospital stay after opera- tion in TAH[(8.9?1.1)days]group was significantly longer than that of TVH[(5.7?2.4)days]or LAVH [(6.3?1.9)days] groups(P＜0.01).The average expenses for medical treatment in LAVH[(7273?938)yuans] group was significantly more than that of TAH[(5594?308)yuans]or TVH[(5450?167)yuans]groups(P＜0.01).But the lesion and the complication after operation of three groups had no difference.Conclusion Different procedures for total hysterectomy have their own advantage and disadvantage.The operation procedure must take ac- count of the economy,echnique of medical treatment and the condition of the hospital.

Objective To investigate the efficiency of three methods to detect HPV infection of desquamated cervical epithelial cells and the relationship between methods and TCT.Methods hC2 method was used in disconnecting the HPV DNA chain in the samples to hybrid captures,and examine the 13 types of HPV which were highly related to cervical carcinoma.Q-PCR was first used to extract HPV DNA of samples and expanded nucleotide to be examined on Q-PCR to obtain results directly.MPHC was used to extract HPV DNA and to amplify nucleotide.The products was added to micro-well plate to proceed hybridization,and enzyme label was added,and results were studied in the enzyme labelling apparatus.The results of the latter two methods were the same as hC2.hC2 matched Q-PCR was used to examine 260 eases of desquamated cells from HPV infection against 200 cases of desquamated cells from HPV infection,and the results were compared by using MPHC matching examination.Results 1.With three methods,HPV infection was found to be 100% in all the abnormal cervical squamous epithelial cells.2.The sensitivity of the methods,howerer,was different.The QFCR and MPHC had higher positive rate than hC2.Positive HPV infection rate with Q-PCR and MPHC was the same as that of hC2 in the majority of cases,as in a few cases,it was positive with Q-PCR and MPHC but negative with hC2 alone False positive rate was 2% in MPHC.Conclusion HPV testing combined with the TCT routine is the best screening program for detecting cervical cancer and precursor of cervical careinoma.